[Advance of endoscopic surgery--practical technique by video and its replacement of conventional surgery]

The recent phenomenal success of laparoscopic cholecystectomy has led to replacement of conventional abdominal surgery as the standard treatment of gall bladder diseases. In an enterprising attempt to expand clinical indications for this minimally invasive form of surgery, physicians and surgeons of the various specialties have been looking to endoscopic operations for benign and/or malignant diseases. Endoscopic surgery usually combines the advantages of less postoperative pains and early return to routine activities with clinical efficacy equivalent to the conventional operation whenever its indication is right. This Symposium was held to discuss the practical technique demonstrated by videotape and its operative effectiveness in the areas of esophageal/gastric/colorectal cancers and intrathoracic/hepatobilliary/gynecological diseases, as well as in the fields of endourology and arthroscopic surgery in shoulder and knee joint. The physicians and even surgeons, a decade ago, seemed to have no inkling of the update endoscopic/laparoscopic revolution. We have, similarly, no imagination of knowing what comes to our surprise being stored in the 21st century. In evaluating any new surgical technique, randomized clinical trials are necessary to be carried out, comparing the new technique with the conventional one. Furthermore, we have to ask ourselves not only what we can do but why we should do it for the quality of life of our patients.